Assessment Of Health Related Quality Of Life In Patient Followed Radical Cystectomy And Urinary Diversion

Objective To assesse the differences of health related quality of life(HRQOL) in patient followed radical cystectomy and three different types of urinary diversion using FACT-BL scale.Finding out which one offered the best HRQOL.Methods: 88 patients underwent radical cystectomy and urinary diversion for invasive bladder cancer from 2002 to 2006 at our hospital.HRQOL was assessed using FACT-BL.The following scores were calculated from the FACT-BL questionnaire and list: physical well-being(PWB), social/family well-being(SWB), emotional well-being (EWB), functional well being(FWB), total FACT-G, overall bladder-specific subscale and total FACT-BL. A high FACT score indicated a high level of HRQOL.The medical records of each patient were reviewed.Clinical parameters,including age,type of diversion,pathological status and sex,were recorded.Statistical analyses were performed using the Kruskal-Wallis H test and chi-square test for categorical variables.A P value less than 0.05 was considered to indicate statistical significance.Results: A total of 51 answered questionnaires were returned to us.These patients included 16 with an IC,14 with a CR,and 21 with a NB.The comparison between respondents and non-respondents revealed no significant differences in the percent of males, follow-up years and pathological stage T3 or greater,but the mean age of non-Respondents was older than respondents.Among the respondents,the age at surgery was significantly younger in NB group than other two groups (P=0.019) , while the percent of males, follow-up years and pathological stage T3 or greater revealed no significant differences.FACT-BL scores found no significant differences between IC and CR groups in all domains.The NB group got significantly higher scores in PWB,SWB,BSS and FACT-BL than other two groups, indicating that the HRQOL is higher in patients followed orthotopic neobladder.Conclusions: These is no significant difference in HRQOL between patients followed ileal conduit and continent reservoir. The HRQOL is better in patients followed orthotopic neobladder than that followed ileal conduit and continent reservoir, indicating that orthotopic neobladder should be considered prior when making a dicision about which urinary diversion should be used.